CHAPTER 5
POISONING, DRUG ABUSE, AND HAZARDOUS
MATERIAL EXPOSURE
As a Hospital Corpsman, you may encounter
patients as the result of poisoning, drug overdose, or
exposure to hazardous materials. Such patients may
initially present with no symptoms or with varying
degrees of overt intoxication. The asymptomatic
patient may have been exposed to or ingested a lethal
dose of a substance but not exhibit any manifestations
of toxicity. A patient with mild symptoms may
deteriorate rapidly, so observe them closely.
Potentially significant exposures should be observed
in an acute care facility whenever possible.
Remember, though: We are not always in a hospital
environment, and we must be prepared to deal with
each situation when and wherever it should present
itself.
In this chapter, we will discuss the assessment and
treatment for ingested, inhaled, absorbed, and injected
poisons.
Drug abuse assessment and treatment
procedures, patient handling techniques, and the
recognition of hazardous material (HAZMAT)
personal safety guidelines and information sources
will also be covered. The last part of the chapter will
cover rescue, patient care, and decontamination
procedures for patients exposed to HAZMAT.
NOTE: Prior to deployments and operational
commitments, commands are strongly
r e c o m m e n d e d
t o
c o n t a c t
t h e
a r e a
Environmental Preventive Medicine Unit
(EPMU) for current, specific, medical
intelligence, and surveillance data. With this
information at hand, the local preventive
medicine authority can identify, prevent, and
treat conditions not common to the homeport
area. The cognizant EPMU will provide data
through MEDIC, (Medical, Environmental,
D i a g n o s i s , I n t e l l i g e n c e a n d C o u n t e r-
measure). Formally called a
Disease Risk
Assessment Profile (DISRAP), MEDIC is a
c o m p r e h e n s i v e ,
c o n s t a n t l y
u p d a t e d
management tool. MEDIC is an invaluable
aid for identifying at-risk communicable
diseases, immunization requirements, and
as applies especially to this chapterlocal
pests and environmental dangers.
POISONING
LEARNING OBJECTIVE:
R e c a l l
assessment and treatment procedures for
ingested, inhaled, absorbed, and injected
poisons
A poison is a substance that, when introduced into
the body, produces a harmful effect on normal body
structures or functions. Poisons come in solid, liquid,
and gaseous forms, and they may be ingested, inhaled,
absorbed, or injected into the system.
Every chemical in a sufficient dose can cause toxic
effects in a humanor in any organism. The amount
or concentration of a chemical and the duration of
exposure to it are what determine the chemicals dose
and toxicity. A 16th century quotation from Paracelsus
states, Dose alone makes a poison. . . .All substances
are poisons, there is none which is not a poison. The
right dose differentiates a poison and a remedy.
A poisoning is defined as the presence of signs or
symptoms associated with exposure or contact with a
substance. If there are no clinical manifestations or
toxic effects, the incident is simply an exposure or a
contact with a potentially poisonous substance. Just
being exposed to a chemical does not mean that a
poisoning has or will occur. It is a matter of dose and
a few other variables (e.g., age, sex, individual
resistance, or state of health) that determine if, or what,
toxic effects will occur.
ASSESSMENT AND TREATMENT
OF PATIENT
In most cases, ASSESSMENT AND TREATMENT
OF THE PATIENT IS MORE IMPORTANT THAN
EFFORT TO IDENTIFY AND TREAT A SPECIFIC
POISON. Supportive therapymanaging the ABCs
(Airway, Breathing, and Circulation) of basic life
support and treating the signs and symptomsis safe
and effective in the vast majority of poisonings.
Extraordinary means to enhance elimination of the
poison (hemodialysis and hemoperfusion) are seldom
needed. Except for agents with a delayed onset of
5-1